Splinting after Carpal Tunnel Surgical Treatment: Does It Really Matter?

Abstract

Background: Splinting of the wrist after carpal tunnel release (CTR) has been practiced by many surgeons especially in North America. The main reason wasto prevent possible adverse events of bowstringing of flexor tendons and the median nerve, pillar pain, entrapment of the median nerve in scar tissue and wound dehiscence. Studies on the effect of splinting after standard CTR had dismal results. The duration of splinting in standard CTR has been either too long (for 2-4 weeks) or too short (48 hours only). Objective: The aim of our study was to compare the effects of post-operative splinting for duration of one week with no splinting. Patients and Methods: All 20 of our patients underwent a standardized open CTR. Post operatively, they were randomized into a splinted (n=10) and a non-splinted (n=10) group. The splint was kept for 2 weeks. Patients were reviewed at regular intervals of one week, two weeks and three months. At each follow up, these patients were clinically assessed for outcome of the Boston questionnaire. Results: All patients presented with significant improvement in the post-operative evaluation within each group. However, there was no significant difference between the two groups for any of the outcome measurements at sequential and at final follow-up. Conclusion: We concluded that wrist splinting in the immediate post-operative period has no advantage when compared with the non-splinting wrist after a standard open carpal tunnel release.